title: Operative management of penetrating carotid artery injuries.
abstract: OBJECTIVE
  To analyse management and outcomes of carotid artery (CA) injuries.
  
  
  METHODS
  Retrospective study of the patients in the combat operations in Chechnya (1999-2002) and in peacetime (2003-2009).
  
  
  METHODS
  A total of 46 patients with missile (27) and stab (19) wounds, who had common and internal CA injury, underwent an open surgery. Temporary shunts (TSs) were placed in eight patients with more severe injuries.
  
  
  METHODS
  Retrospective analysis of patients' data.
  
  
  RESULTS
  CA ligation and CA repair were performed in 9 and 37 patients, respectively. Of the nine patients with CA ligation, five developed neurologic deficit; the remaining four patients died (100% of poor outcomes). Of the 37 patients with blood flow restoration, nine patients died and neurologic deficit persisted in two patients (30% of poor outcomes) (p < 0.05). Among patients with TS, three patients died and two had stable neurologic deficit (63% of poor results). Of the patients without TS, 10 patients died and five had neurologic disorders (56% of poor outcomes) (p = 0.53).
  
  
  CONCLUSIONS
  CA repair is the method of choice in CA injury. TS use does not result in a decreased mortality rate or neurologic deficit reduction in patients with severe injuries.
authors.affiliation: Department of War Surgery, The Military Medical Academy named after S.M. Kirov, Saint-Petersburg, Russia. vreva@mail.ru
authors.forename: V A
authors.initials: VA
authors.lastname: Reva
authors.forename: A A
authors.initials: AA
authors.lastname: Pronchenko
authors.forename: I M
authors.initials: IM
authors.lastname: Samokhvalov
mesh_terms: D000328:Adult; D000714:Anastomosis, Surgical; D001753:Blast Injuries / Q000175:diagnosis / Q000401:mortality / Q000601:surgery*; D020212:Carotid Artery Injuries / Q000175:diagnosis / Q000401:mortality / Q000601:surgery*; D016009:Chi-Square Distribution; D005260:Female; D006801:Humans; D008026:Ligation; D008297:Male; D009104:Multiple Trauma / Q000175:diagnosis / Q000401:mortality / Q000601:surgery*; D019838:Neck Injuries / Q000175:diagnosis / Q000401:mortality / Q000601:surgery*; D009422:Nervous System Diseases / Q000209:etiology; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D012426:Russia; D012720:Severity of Illness Index; D013536:Suture Techniques; D013997:Time Factors; D016896:Treatment Outcome; D014656:Vascular Surgical Procedures / Q000009:adverse effects / Q000401:mortality; D057772:Vascular System Injuries / Q000175:diagnosis / Q000401:mortality / Q000601:surgery*; D014680:Veins / Q000637:transplantation; D014857:Warfare; D014950:Wounds, Penetrating / Q000175:diagnosis / Q000401:mortality / Q000601:surgery*; D014951:Wounds, Stab / Q000175:diagnosis / Q000401:mortality / Q000601:surgery